Objective To determine the cleaning and the shortest disinfectant time for gastroscope Methods 1? g/ml HBsAg and 3? 108/ml bacteria of Aureus Staphylococci(ATCC 6538),Escherichia coli(ATTC 8099),Bacterium earuginosum(ATCC 27853)were artificially spreaded on the body of gastroscope ,biopsy hole and biopsy clamp.The gastroscope was routinely cleaned and disinfected.HBsAg and pathogens in the samples,which collected before and after cleaning the gastroscope and 3min,5min,10min after disinfection,were tested by using ELISA and bacteria culture,respectively.Results Pathogen and HBsAg can be detected before cleaning the gastroscope.Pathogen can also be detected,but HBsAg disappears after cleaning.Both HBsAg and pathogen was negative 3 min after gastroscope was immersed in glutaraldehyde.Conclusion The tests for pathogens and HBsAg can be negative after gastroscope was cleaned and immersed in 2％ glutaraldehyde for 3 min.

Objective To investigate the relationship of antishock effect of arginine vasopressin(AVP) on hemorrhagic shock and its relationship with Rho kinase.Methods Hemorrhagic shock(40 mmHg for 2 h) Wistar rats were treated respectively by AVP(0.4 U/kg),Rho kinase specific inhibitor,Y-27632(30 ?g/kg),or these 2 reagents.The pressor effect of norepinephrine(NE) on these rats and the contractility of their isolated superior mesenteric artery(SMA) were observed.Isolated SMAs from hemorrhagic shock rats were adopted to observe the effects of AVP on vascular reactivity and calcium sensitivity and its relationship to Rho kinase with an isolated organ perfusion system.Results AVP at the concentration of 0.4 U/kg significantly improved the pressor effect of NE and the contractile response of SMA.While,Y-27632(30 ?g/kg) abolished these beneficial effects of AVP.The vascular reactivity and calcium sensitivity of SMA were significantly decreased following hemorrhagic shock.AVP at the concentration of 0.5 and 5 nmol/L significantly increased the decreased vascular reactivity and calcium sensitivity.These effects of AVP were abolished by Y-27632(10 ?mol/L).Conclusion Rho kinase may take part in the action of AVP on hemorrhagic shock via improving shock induced vascular hyporeactivity and calcium desensitization.

Objective To observe the diagnostic value of Omeprazole (Losec) test in gastro-esophageal reflux disease. Methods According to clinical manifestations and results of esophageal 24 h pH monitoring and gastro-esophageal endoscopy, 152 patients with reflux symptoms (123 GERD, 29 non-GERD) were randomly, double-blindly divided into group A (Omeprazole 20 mg/d for 1 week), group B(Omeprazole 40 mg/d for 2 weeks), and group C (placebo at the first week, Omeprazole 40 mg/d at the 2 nd week). Symptom score from heartburn, acid regurgitation, food regurgitation, and substernal pain, was recorded before and after taking Omeprazole or placebo. Results After taking Omeprazole 1 week, the symptom score decreasing from GERD patients of group A, B and C was 5.0?4.8、4.9?4.6、2.3?4.0 respectively, score decreasing 2 was the best critical value for GERD diagnosis. There was no difference between Omeprazole 20 mg/d and 40 mg/d for 1 week, the results showed that Omeprazole test (20 mg/d for 1 week) has the best diagnostic value for GERD, the diagnostic sensitivity was 82.5%, specificity was 40.1%, coincident rate was 76.7%. Conclusion Omeprazole test is reliable for GERD diagnosis.

Objective To evaluate the clinical application of fecal elastase test in exocrine insufficiency of pancreatic disease. Methods The fecal elastase 1 was detected by ELISA method in 55 patients with chronic pancreatitis, 21 with pancreatic cancer and 25 with nonpancreatic digestive disease, and the urine BT PABA was measured by DACA method simultaneously. Results The fecal elastase 1 and urine BT PABA excretion in patients with chronic pancreatitis and pancreatic cancer were much lower than those in patients with nonpancreatic disease ( P

Teaching of clinical skills is an important bridging phase from preclinical medicine to clinical practice.It is also an important element of medical students'clinical skills training.According to the character of internal medical cardiology,we should enhance the training of their clinical thinking ability,medical communication competence,and clinical operating ability to get satisfactory teaching effect.

Objective To compare the resuscitation effect of 6% hydroxyethyl starch (HES) of different molecular weight in normal saline on hemorrhagic shock in rats. Methods Hemorrhagic shock model was established in 50 SD rats by 45% hemorrhage,and then they were equally divided into 5 groups. The rats were administered with HES40/,HES130/,HES200/normal saline,Voluven or Haes. Their mean arterial blood pressure (MAP),left intraventricular systolic pressure (LVSP),the maximal change rate of left intraventricular pressure (?dp/dtmax) of hemorrhagic shock rat were observed. Meanwhile,the artery blood gas,the survival time and 24-hour survival rate were also observed. Results Similar hemodynamic parameters values were obtained in the rats treated with our HES and those with Voluven or Haes. HES130 and HES200 prolonged the survival time of shocked animals in comparison with HES40. Among the 3 types of HES,HES200 had the best effect,which is equivalent to Voluven and Haes. Conclusion HES of 3 molecular weights have beneficial effect on hemorrhagic shock,and HES200 exerts best.

Method We used biomechanical methods in controlling strain of anterior tibial muscles of rabbits .Objective To observe the histological and enzymohistochemical change after sprain.Result Experimental model of muscle sprain could be made with yield load which was about 128% of the body weight extracting anterior tibial muscle of the rabbits.Some of the muscle fibers broke near the junction between muscle and the tendon. Conclusion Fibrosis of endomysium and scar formation at the injury might be an important cause of frequent recurrence of muscle sprain.

Objective: To design and confirm the cleavage activity of ribozyme Rz217 to oncogene ki-rasG12V messenger RNA and search for a new method for gene therapy targeting oncogene ki-ras. Methods: According to Symon' s principle,design an ribozyme specific for ki-rasc12v mRNA, both the constructs for transcription in vitro of ribozyme Rz217 and ki-ras exonl and the mammalian expression constructs of ribozyme Rz217 were constructed by DNA recombinant technique,ribozyme Rz217 and ki-ras exonl mRNA was obtained by transcription in vitro with T7 and SP6 RNA polymerase. Pancre atic carcinoma cell line PaTu8988 and human hepatocellular carcinomacell line BEL7404 were transfected with Rz217 mammalian expression constructs and the level of endogenous ki-rasG12V mRNA or ki-ras mRNA was determined by semiquantitative RT-PCR. Results: Not only in vitro but also in vivo, ribozyme Rz217 can cleave the mRNA of oncogene ki-ras (G12V) in site-specific manner and can not cleave the mRNA of wild-type ki-ras. Conclusion: Ribozyme Rz217 can cleave oncogene ki-rasc12v mRNA and the cleveage is specific for ki-rasG12V mRNA.

Objective To explore the effect of ILK on myocardium contraction following hemorrhagic shock .Methods With iso-lated cardiac papillary muscle and isolated heart ,the contraction of papillary muscle and hemodynamic parameters (left intraventricu-lar systolic pressure(LVSP) ,the maximal change rate of left intraventricular pressure were measured .Results Compared with nor-mal control hearts ,ILK activity ,contractile response of cardiac papillary muscle and hemodynamic parameter were decreased signifi-cantly gradually in shock heart at the 1 ,2 h(P<0 .05) ,and the change of ILK activity was positive correlative with contractile re-sponse and hemodynamic parametert .With ILK agonist [phosphatidylinositol(3 ,4 ,5)trisphosphate ,PLTP] the dysfunction of con-tractile response and hemodynamic parameter could be improved significantly (P<0 .05) ,while these improvement could be abol-ished by ILK specific inhibitor(P<0 .05) .Conclusion ILK play important role in the regulation of cardiac contractility following hemorrhagic shock .

BACKGROUND:Sodium butyrate, a histone deacetylase inhibitor, can inhibit cell proliferation, and induce apoptosis and differentiation of various cancer cells. However, the role of sodium butyrate combined with tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) on lung cancer stem cells remains unclear. OBJECTIVE:To explore the effect of sodium butyrate combined with TRAIL on biological behaviors of lung cancer stem cells. METHODS:Magnetic bead separation was used to separate lung cancer stem cells (CD133+) from human lung adenocarcinoma A549 cells. After the lung cancer stem cells were treated with simple DMEM/F12, DMEM/F12 containing sodium butyrate (5 mmol/L), TRAIL (50 μg/L) or sodium butyrate combined with TRAIL, the cell proliferation within 96 hours of culture was determined by MTT assay; the apoptosis within 24 hours of culture was measured by flow cytometry; the cell migration within 48 hours of culture was detected by cell scratch test; the expression levels of pluripotent transcription factors (Oct4, Sox2 and Nanog) within 48 hours of culture were detected using western blot analysis. RESULTS AND CONCLUSION:The CD133+ lung cancer stem cells were successfully enriched from human lung adenocarcinoma A549 cells. MTT assay showed that sodium butyrate and TRAIL significantly inhibited the proliferation of lung cancer stem cells (P< 0.05), and the combination effect was even stronger (P < 0.05). Results from flow cytometry analysis and scratch test showed that sodium butyrate or TRAIL induced apoptosis and inhibited cell migration of lung cancer stem cells (P < 0.05), and the combination of sodium butyrate and TRAIL showed a stronger effect (P < 0.05). In addition, the expression levels of Oct4, Sox2 and Nanog were significantly down-regulated by sodium butyrate (P < 0.05), TRAIL or sodium butyrate combined with TRAIL, and the combination effect was stronger (P < 0.05). In conclusion, sodium butyrate and TRAIL have synergistic effects on lung cancer stem cells, indicating a new way for treatment of lung cancer.